Chronic Suppurative Otitis Media Contributory Factors and their Prevention

Background: Chronic suppurative otitis media has declined in the developed countries because of better health resources and better socioeconomic status of the people, but it still remains a major health problem in developing countries like Pakistan. Chronic suppurative otitis media (CSOM) is relatively common among illiterate people having poor socioeconomic status residing in the rural areas. Objective: To identify the contributory factors responsible for chronic suppurative otitis media and to devise strategies to prevent them. Study Design: Cross sectional observational study. Settings: This study was conducted in the department of ENT and Head & Neck surgery allied hospital (FMU) Faisalabad Pakistan. Duration: Two years from September 2016 to August 2018. Methodology: A total of 150 patients with CSOM, both tubotympanic and atticoantral types, were included. The patients of either gender with CSOM, both tubotympanic and atticoantral types, ranging from 03 to 64 years and giving consent for any surgical intervention if required were included in the study. Patients below 03years and above 64 years, having acute suppurative otitis media with complication, and patients not willing for any surgical intervention were excluded from the study. Results: Out of 150 patients of the study 60% patients were males and 40% were females with male : female ratio of 1.5 : 1. The age range was found to be 3-64 years with mean age of 28.9 years. Socioeconomic status showed that 62.8% patients with CSOM belonged to poor class (tubotympanic-46.8% & atticoantral -16%), 23.9% patients had middle class (tubotympanic-16.6% & atticoantral-7.3%) and 13.3% patients belonged to upper class (tubotympanic - 11.3% & atticoantral – 2%). 84 patients (56%) were under matric (tubotympanic-42% & atticoantral – 14%). 57.2% patients were rural residents and 42.8% patients were urban residents in case of tubotypmpanic type of CSOM while 55.2% patients were rural and 44.8% patients were urban in case of atticoantral type of CSOM. SPSS software version 10 was used to analyse the data. Chi square test was applied for analysis. Tubotympanic type of CSOM cases were treated conservatively along with surgical treatment where indicated. All cases of atticoantral type of CSOM were treated by surgery. Conclusion: CSOM is still an important public health problem in developing countries like Pakistan due to poverty, illiteracy, malnutrition, lack of health education and people living in substandard & rural areas. It is the need of the hour that health education programs should be organized to raise the awareness about the disease among the people.